RU2377964C2 - Intraocular lens - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: intraocular lens contains bearing supports and an optical part consisting of internal and external components with optical surfaces located one inside the other with refraction indices differing by 0.03. Each component comprises at least two optical surfaces, each having at least one spherical element with its optical axis aligned with the central optical axis of the intraocular lens, and/or one optical element formed by a rotation surface of at least the second order. The bearing supports and the external component are made of the same or different optically transparent materials. The optical surfaces of the internal component are presented with spherical elements of diametre 2.0-2.2 mm extended with a disk of thickness 100-200 mcm with its total diametre less than that of the external component by 0.5-1.0 mm.

EFFECT: application of said intraocular lens ensures close and distant vision.

2 dwg, 1 tbl, 2 ex

Description

The invention relates to medicine, namely to ophthalmology, and is intended for the surgical treatment of cataracts.

After cataract removal and implantation of an artificial lens of the eye (IHG), the patient’s natural desire is good vision at any distance from the object. However, the absence of changes in the refractive power of ICH leads to a complete loss of accommodation ability - artifact presbyopia. An effective method for correcting artifactic presbyopia is the implantation of multifocal artificial lenses.

Known artificial lens of the eye (RF patent No. 2242189), providing vision near and far. The specified IHG contains an optical part consisting of internal and external components located one inside the other with different refractive indices, and one of the surfaces of the internal component forms the central part of one of the external surfaces of the external component.

Known artificial lens of the eye (RF patent No. 2239391), taken as a prototype, also providing vision near and far. In the indicated IHG, the optical part is also made integral and contains internal and external components located one inside the other with different refractive indices, however, the components do not have common optical surfaces.

The given IHG designs do not require additional vision correction after implantation, however, their common significant drawback is the occurrence of light scattering circles in the patients eye when looking at the light source, blinding in bright light, light flickering and glimpses, ghosting around the objects under consideration. The cause of these undesirable phenomena is the presence of a visible transition zone between the internal and external components. The active nature of complaints is shown in up to 50% of cases.

The technical problem solved by the invention is the creation of IHG, providing vision near and far, as well as the expansion of the IHG arsenal.

The technical result of the invention is the creation of IHG with a reliable design of the optical part, providing defect-free, comfortable vision near and far.

The stated technical problem is solved in that in the artificial lens of the eye, containing the supporting elements and the optical part, consisting of internal and external components with optical surfaces located one inside the other, differing by 0.03 refractive indices, each component contains, at least two optical surfaces, each of which has at least one spherical element, the optical axis of which coincides with the central optical axis of the artificial lens, and / or one optical element formed by a rotation surface of at least a second order, wherein the supporting elements and the outer component are made of one or different optically transparent materials, according to the invention, the optical surfaces of the inner component are made with a diameter of 2.0-2.2 mm, further turning into a disk with a thickness of 100-200 microns, the total diameter of which is less than the diameter of the external component by 0.5-1.0 mm.

The invention is illustrated by drawings.

In Fig.1 is a frontal view of the IHG, in Fig.2 is a side view of the IHG, where 1 is the supporting elements, 2 is the optical part, 3 is the outer component of the optical part, 4 is the spherical element of the internal component, 5 is the disk into which the spherical element of the internal component passes.

The proposed model of IHG contains the supporting elements 1 and the optical part 2. The optical part of the IHG 2 consists of the outer 3 and the inner 4 components located one inside the other. The supporting elements 1 and the outer component 3 of the optical part are made of one or different optically transparent materials (for example, the outer component of the optical part is made of the material according to patent No. 2239391, and the supporting elements are made of the same material or polypropylene fiber). The internal component of the optical part of the IHG contains at least two optical surfaces, each of which has at least one spherical element 4 formed by a rotation surface of at least second order. The optical axis of the spherical element 4 coincides with the Central optical axis of the IHG. The external component of the optical part of the IHG 3 also contains at least two optical surfaces, each of which has at least one spherical element formed by a rotation surface of at least second order. The optical axis of the external component 3 coincides with the Central optical axis of the IHG. The internal and external components of the optical part of the IHG are made of materials with refractive indices differing by 0.03. The difference in the refractive power of the ICH (ΔD) of the center of the lens (internal component) and the periphery (external component) determines the depth of accommodation of the ICH. The distance of the best near vision (optimal distance of 33 cm) depends on ΔD. The value of ΔD depends on the radii of curvature of the optical surface of the external and internal components. Table 1 shows the values of D - refractive power of the ICH according to the invention with different radii of curvature of the optical surface of the external and internal components. The calculations were performed for IHG having a diameter of the outer component of the optical surface of 6.0 mm and a diameter of a spherical element of the inner component of the optical surface of 2.0 mm. In column 1 - the refractive power of the central zone of the IHG, providing the best vision in the distance; 2 - refractive power of the peripheral zone of the IHG, providing the best vision near.

The radius of curvature of the external component of the IHG → 17.79 16.9 16.09 15.36 14.69 14.08 13.52 D →
external component 19 twenty 21 22 23 24 25 ΔD The radius of curvature of the spherical element of the internal component of the ICH ↓ D ↓ internal component one 2 one 2 one 2 one 2 one 2 one 2 one 2 2,3 17.79 19 16.5 18.8 17.5 19.8 18.5 20.8 19.5 21.7 20.5 22.7 21.5 23.7 22.4 24.7 2,4 16.9 twenty 16,4 18.8 17.4 19.8 18,4 20.8 19,4 21.7 20,4 22.7 21.3 23.7 22.3 24.7 2.5 16.09 21 16.3 18.8 17.3 19.8 18.3 20.8 19.3 21.7 20,2 22.7 21,2 23.7 22.2 24.7 2.6 15.36 22 16,2 18.8 17,2 19.8 18.2 20.8 19.1 21.7 20.1 22.7 21.1 23.7 22.1 24.7 2.7 14.69 23 16.1 18.8 17.1 19.8 18.0 20.8 19.0 21.7 20,0 22.7 21.0 23.7 22.0 24.7 2,8 14.08 24 16,0 18.8 16.9 19.8 17.9 20.8 18.9 21.7 19.9 22.7 20.9 23.7 21.9 24.7 2.9 13.52 25 15.8 18.8 16.8 19.8 17.8 20.8 18.8 21.7 19.8 22.7 20.8 23.7 21.7 24.7 3.0 13.0 26 15.7 18.8 16.7 19.8 17.7 20.8 18.7 21.7 19.7 22.7 20.6 23.7 21.6 24.7 3,1 12.51 27 15.6 18.8 16.6 19.8 17.6 20.8 18.6 21.7 19.5 22.7 20.5 23.7 21.5 24.7 3.2 12.07 28 15,5 18.8 16.5 19.8 17.5 20.8 18,4 21.7 19,4 22.7 20,4 23.7 21,4 24.7

As can be seen from the table, for various combinations of the radii of the optical surfaces of the external and internal components, differing by 0.03 refractive indices of the material, it is possible to obtain IHG with different depths of accommodation (ΔD), which ensures almost continuous high-quality vision at any distance from the object.

The internal component 4 of the IHG is made in the form of a spherical element with a thickness of 100-200 μm, which, outside the diameter of 2.0-2.2 mm, goes into the disk 5. This design of the IHG eliminates the reflection from the side surfaces of the spherical element of the rays entering the eye and causing such undesirable effects as the occurrence of light scattering circles when looking at a light source, blinding in bright light, light flickering and flashes, ghosting around the objects in question.

The internal component, having a thickness of 100-200 μm, does not increase the total thickness of the ICH, and it can be used in the surgery of small incisions without changing the implantation techniques.

The internal component of the IHG has a diameter less than the diameter of the external component by 0.5-1.0 mm, which allows you to use almost the entire optical part of the IHG in image formation.

The invention is illustrated by clinical examples:

Example 1

Patient P., 71 years old, turned to FGU MNTK “Eye Microsurgery” named after Acad. S.N. Fedorova about complicated postcapsular cataract of both eyes.

An objective examination:

According to visometry:

Vis OD = 0.5 n / a

Vis OS = 0.5 n / a

According to keratometry:

OD 43.00 ax 4 ° OS 42.75 ax 174 ° 44.00 ax 94 ° 44.00 ax 84 °

Pneumotonometry:

Tn OD 17 mmHg

Tn OS 16 mmHg

According to biometrics:

depth per. the cameras OD 3.00 OS 3.00 lens 4,57 4.64 eye length 23.57 23.50

Biomicroscopy: OD: the mucosa is calm, the cornea is transparent, the anterior chamber is of medium depth, the moisture of the anterior chamber is transparent, the pupil is round, 3.0 mm in diameter, good response to light, the lens is cloudy, core density 1, pronounced opacities under the back capsule. OS: the mucous membrane is calm, the cornea is transparent, the anterior chamber is of medium depth, the moisture of the anterior chamber is transparent, the pupil is round, 3.0 mm in diameter, good response to light, the lens is cloudy, core density 1, pronounced opacities under the back capsule.

Ophthalmoscopy: OD: optic nerve disc pale pink, the borders are clear, the course of blood vessels is not changed. OS: optic nerve disc pale pink, the borders are clear, the course of blood vessels is not changed.

Given all the objective data, the patient recommended phacoemulsification of the cataract of the left eye with the implantation of a multifocal intraocular lens with gradient optics Gradiol.

The calculated strength of the IOL is 21 diopters (based on emmetropia).

On May 24, 2007, phacoemulsification of the cataract of the left eye was performed with implantation of a multifocal intraocular lens Gradiol. A 21/24 diopter IOL was implanted on the OS. The postoperative period is reactive. In the early postoperative period:

Vis OS distance = 0.7 s cyl -1.00 D ax 175 ° = 0.8

Vis OS near = 0.5 n / a

BYTYAZ - 30 cm

According to objective refractometry, residual refraction was:

OS sph + 0.75 D cyl - 1.00 D ax 162 °

A keratometric study revealed the absence of induced astigmatism in the left eye:

OS 42.75 ax 166 ° 44.00 ax 76 °

According to pneumonometry:

Tn OS 19 mmHg

On the 1st day according to OS biomicroscopic examination: the mucosa is calm, the cornea is transparent, the anterior chamber is of medium depth, the moisture is transparent, the intraocular lens is in the correct position, centered, the pupil is round, 3 mm in diameter, the iris is calm, slight diastasis between the posterior surface is determined IOL and posterior lens capsule.

After 3 months of follow-up after surgery:

Vis OS far = 0.8 s cyl + 1.0 D ax 755 ° = 0.9

Vis OS near = 0.5 without correction

According to objective refractometry, residual refraction was:

OS sph + 0.00 D cyl + 0.75 D ax 75 °

With a keratometric study:

OS 42.75 ax 166 ° 44.00 ax 76 °

According to pneumonometry:

Tn OS 12 mmHg

The amplitude of the pseudo accommodation was 4.0 diopters.

The nearest point of clear vision is 25 cm.

The patient does not note the development of light phenomena in the postoperative period.

According to BMS OS: the mucosa is calm, the cornea is transparent, the anterior chamber is of medium depth, the moisture of the anterior chamber is transparent, the intraocular lens is in the correct position, centered, the pupil is round, 3 mm in diameter, the iris is calm.

Subjectively, the patient is fully satisfied with the surgical treatment. The high quality of visual functions achieved in the postoperative period and the volume of pseudo-accommodation allowed the patient not to use additional spectacle correction for distance and proximity and to cope with significant visual loads at close range.

Example 2

Patient V., 48 years old, turned to FGU MNTK “Eye Microsurgery” named after Acad. S.N. Fedorova about age-related nuclear cataract of the left eye, artifact of the right eye (a multifocal Gradiol lens was implanted 2 months earlier).

An objective examination:

According to visometry:

Vis OD far = 0.8 s cyl-1,0Dax80 ° = 0.9 Vis OD near = 0.7 n / k

Vis OS far = 0.1 s cyl-1,5Dax85 ° = 0.2 Vis OS near = 0.1 n / k

According to keratometry:

OD 42.75 ax 111 ° OS 43.25 ax 170 ° 43.00 ax 21 ° 42.50 ax 80 °

Pneumotonometry:

Tn OD 20 mmHg

Tn OS 22 mmHg

According to biometrics:

depth per. the cameras OD OS 3.53 lens IOL 4.35 eye length 23.79 23.81

Biomicroscopy: OD: the mucosa is calm, the cornea is transparent, the anterior chamber is deep, the moisture of the anterior chamber is transparent, the pupil is round, 3.0 mm in diameter, good response to light, IOL (Gradiol) in the back chamber in the correct position. OS: the mucous membrane is calm, the cornea is transparent, the anterior chamber is of medium depth, the moisture of the anterior chamber is transparent, the pupil is round, 3.0 mm in diameter, good response to light, the lens is cloudy, core density 2.

Ophthalmoscopy: OD: optic nerve disc pale pink, the borders are clear, the course of blood vessels is not changed. OS: optic nerve disc pale pink, the borders are clear, the course of blood vessels is not changed.

Given all the objective data, the patient was recommended phacoemulsification of the cataract of the left eye with the implantation of a multifocal intraocular lens with Gradiol gradient optics.

The calculated strength of the IOL is 21 diopters (based on emmetropia).

On December 24, 2007, phacoemulsification of the cataract of the left eye was performed with the implantation of a multifocal intraocular lens Gradiol. A 21/24 diopter IOL was implanted on the OS. The postoperative period is reactive. In the early postoperative period:

Vis OS to distance = 1.0

Vis OS near = 0.9 n / a

BYTYAZ - 35 cm

According to objective refractometry, residual refraction was:

OD sph + 0.50 D cyl -0.75 D ax 104 °

A keratometric study revealed a decrease in the degree of preoperative astigmatism:

OS 42.75 ax 106 ° 43.25 ax 16 °

According to pneumonometry:

Tn OD 20 mmHg

On the 1st day according to OS biomicroscopic examination: the mucosa is calm, the cornea is transparent, the anterior chamber is of medium depth, the moisture is transparent, the intraocular lens is in the correct position, centered, the pupil is round, 3 mm in diameter, the iris is calm, slight diastasis between the posterior surface is determined IOL and posterior lens capsule.

The amplitude of the pseudo accommodation was 5.0 diopters.

The patient does not note the development of light phenomena in the postoperative period.

Subjectively, the patient is completely satisfied with the surgical treatment. The high quality of visual functions achieved in the postoperative period and the volume of pseudo accommodation allowed the patient not to use additional spectacle correction for distance and proximity and to cope with significant visual loads at close range.

Claims (1)

An artificial eye lens containing support elements and an optical part consisting of internal and external components with optical surfaces located inside each other with refractive indices differing by 0.03, each component containing at least two optical surfaces, each of which has at least one spherical element, the optical axis of which coincides with the central optical axis of the artificial lens, and / or one optical element formed surface rotation of at least second order, and the supporting elements and the outer component are made of one or different optically transparent materials, characterized in that the optical surfaces of the inner component are made in the form of spherical elements with a diameter of 2.0-2.2 mm, then passing into a disk with a thickness of 100-200 μm, the total diameter of which is less than the diameter of the external component by 0.5-1.0 mm.

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